Publications by authors named "Zucconi M"

Article Synopsis
  • This study investigates how K-complexes (KC), a specific type of brainwave, relate to the effectiveness of Cognitive-Behavioral Therapy for Insomnia (CBT-I), which is the main treatment for chronic insomnia.
  • Researchers conducted a multicenter study with 98 insomnia patients undergoing a 6-8 week CBT-I program, evaluating their sleep using polysomnography and an insomnia severity index before and after treatment.
  • The results indicate that KC density, particularly its change after treatment, can predict how well patients respond to CBT-I and significantly correlates with improved sleep pressure, suggesting KC is an important biomarker for insomnia treatment.
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  • Researchers explored the differences between "brain-first" and "body-first" types of Parkinson's disease by studying patients with isolated REM sleep behavior disorder (iRBD) and their periodic limb movements during sleep (PLMS).
  • Out of the 191 patients examined, 48.2% had a high PLMS index (PLMSi > 15), which was linked to better performance in executive functions despite poorer sleep quality.
  • The study suggests that higher PLMSi correlates with increased wakefulness and decreased overall sleep efficiency, indicating a potential connection between sleep disruptions and cognitive status in these patients.
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  • - The study investigates Sleep State Misperception (SSM) in Insomnia Disorder (ID) patients, who tend to misjudge their sleep latency (how long it takes to fall asleep) and total sleep time compared to healthy individuals.
  • - The research involved twenty ID patients and eighteen healthy controls undergoing polysomnography (PSG) and analyzing their sleep diaries, with a focus on alterations in brain wave patterns during sleep onset and throughout the night.
  • - Results indicated significant differences in brain wave activity, with ID patients showing a low delta/beta ratio and distinctive power changes in certain brain regions, suggesting a relationship between sleep misperception and altered sleep EEG topography.
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Background: The introduction of rapid antigen tests revolutionized the approach to SARS-CoV-2 diagnosis, offering prompt and accurate results with high sensitivity and specificity. Although it is more cost- and time-saving than the gold standard, real-time polymerase chain reaction (RT-PCR), the efficacy in general population screening in both hospital- and community-based settings remains unknown. Moreover, rapid antigen testing is limited by qualitative results.

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This systematic review evaluates the scientific literature on pediatric periodic limb movement disorder (PLMD), adhering to PRISMA guidelines and utilizing PICOS criteria. The search across PubMed, EMBASE, and Scopus yielded 331 articles, with 17 meeting inclusion criteria. Diagnostic criteria evolved, with polysomnography and PLMS index ≥5 required since 2003.

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Article Synopsis
  • - Obstructive sleep apnea (OSA) is a common sleep disorder with low diagnosis and treatment rates, and Continuous Positive Airway Pressure (CPAP/PAP) is the main therapy, although many patients struggle to stick with it.
  • - A network meta-analysis of 50 randomized control trials explored how different types of interventions—Behavioral, Educational, Supportive, and Mixed—impact adherence to CPAP/PAP therapy among OSA patients.
  • - The findings indicate that Supportive interventions are the most effective for improving CPAP adherence, highlighting the need for collaboration among clinicians and a multidisciplinary approach to OSA treatment using a biopsychological framework.
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  • Sleep state misperception (SSM) is a common issue in insomnia disorder, leading to differences between perceived and actual sleep times, which can worsen daytime functioning.
  • The study examined how various sleep measurements (like brain activity patterns) relate to misperceptions of sleep latency (the time taken to fall asleep) and total sleep time in patients with insomnia.
  • Results showed that increased alpha brain activity during sleep onset correlates with misperceptions about sleep duration, reinforcing the idea that heightened brain arousal contributes to SSM difficulties in insomnia patients.
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  • Diagnostic manuals describe insomnia disorder (ID) as leading to daytime fatigue and sleepiness, but patients rarely report sleepiness in clinical settings.
  • A study assessed subjective sleepiness in ID using the Epworth Sleepiness Scale (ESS) and evaluated the impact of cognitive behavioural therapy for insomnia (CBT-I) on daytime functioning and fatigue.
  • Results showed that ID patients had similar sleepiness levels to healthy controls and significantly less than those with excessive daytime sleepiness, indicating a disconnect between daytime functioning and sleepiness in ID, while insomnia severity correlated with fatigue.
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Benzodiazepine (BDZ) misuse is a growing health problem, with 1-2% of patients under BDZ treatment meeting the criteria for use disorder or dependence. Although BDZ addiction potential has been known for decades, much remains unknown its effects on brain functions. The aim of this study was to assess the neuropsychological and neurophysiological profile of a group of chronic insomniacs taking long-term high doses of benzodiazepine.

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Herein we focus on connections between genetics and some central disorders of hypersomnolence - narcolepsy types 1 and 2 (NT1, NT2), idiopathic hypersomnia (IH), and Kleine-Levin syndrome (KLS) - for a better understanding of their etiopathogenetic mechanisms and a better diagnostic and therapeutic definition. Gene pleiotropism influences neurological and sleep disorders such as hypersomnia; therefore, genetics allows us to uncover common pathways to different pathologies, with potential new therapeutic perspectives. An important body of evidence has accumulated on NT1 and IH, allowing a better understanding of etiopathogenesis, disease biomarkers, and possible new therapeutic approaches.

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  • * A study of 55 iRBD patients explored how cognitive reserve (CR) impacts their cognitive performance, revealing that those with higher CR levels had less mild cognitive impairment and performed better on memory tests.
  • * The findings suggest that CR could serve as a protective factor against cognitive decline in iRBD patients, laying the groundwork for future research on CR's role in disease progression and cognitive deterioration.
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Actigraphy has a consolidated role in Insomnia and Circadian Rhythm Sleep-Wake Disorders (CRSWD) and recent studies have highlighted the use of actigraphy for narcolepsy and REM sleep behaviour disorder (RBD). This review aims at summarising the results of studies published over the last decade regarding the use of actigraphy. Thirty-five studies proved eligible, and results were analysed separately for insomnia, narcolepsy and RBD.

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The aim of this meta-analysis is twofold: (a) to assess cognitive impairments in isolated rapid eye movement (REM) sleep behavior disorder (iRBD) patients compared to healthy controls (HC); (b) to quantitatively estimate the risk of developing a neurodegenerative disease in iRBD patients according to baseline cognitive assessment. To address the first aim, cross-sectional studies including polysomnography-confirmed iRBD patients, HC, and reporting neuropsychological testing were included. To address the second aim, longitudinal studies including polysomnography-confirmed iRBD patients, reporting baseline neuropsychological testing for converted and still isolated patients separately were included.

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Recent evidence demonstrated that neuropsychological assessment may be considered a valid marker of neurodegeneration in idiopathic REM sleep behaviour disorder (iRBD). However, little is known about the possible neuropsychological heterogeneity within the iRBD population. This retrospective study aimed to identify and describe different neuropsychological phenotypes in iRBD patients by means of a data-driven approach using latent class analysis.

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Objective: This study was undertaken to follow up predictive factors for α-synuclein-related neurodegenerative diseases in a multicenter cohort of idiopathic/isolated rapid eye movement sleep behavior disorder (iRBD).

Methods: Patients with iRBD from 12 centers underwent a detailed assessment for potential environmental and lifestyle risk factors via a standardized questionnaire at baseline. Patients were then prospectively followed and received assessments for parkinsonism or dementia during follow-up.

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Underlying neural mechanisms and cognitive implications of non-Rapid Eye Movement (NREM) sleep in isolated Rapid Eye Movement (REM) sleep behavior disorder (iRBD) are not yet fully elucidated. This study aims to evaluate brain metabolic connectivity of the anterior default mode network (ADMN) underlying a waveform that is an hallmark of NREM sleep, namely K-complex (KC) and their implication for neuropsychological functioning in iRBD patients. Combining polysomnographic and multivariate molecular imaging (FDG-PET) approaches may provide crucial insights regarding KCs role in the prodromal stages of synucleinopathies.

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Study Objectives: We tested the hypothesis that patients with extreme sleep state misperception display higher levels of psychopathology and reduced quantitative estimation abilities compared to other patients with insomnia. Secondary aims included the evaluation of group differences in subjective self-reported quality of life and sleep quality and objective sleep parameters.

Methods: In this cross-sectional, observational study, 249 patients with insomnia underwent a video-polysomnography with a subsequent morning interview to assess self-reported sleep estimates and filled in a large battery of questionnaires.

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Article Synopsis
  • The 'catalogue of knowledge and skills' for sleep medicine serves as a framework for developing a curriculum, textbook, and examination in the field.
  • Originally created by the European Sleep Research Society in 2014, the catalogue has been updated to reflect changes in sleep disorder classifications, scoring manuals, and advances in sleep science.
  • The revised catalogue highlights a shift in sleep medicine's importance across various medical specialties, emphasizing the need for education and evaluation of sleep disorders within disciplines like cardiology, psychiatry, and pediatrics.
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Propriospinal myoclonus (PSM) consists of paroxysmal and sudden jerks involving axial flexion trunk and hip muscles, conditioning sudden myoclonias of the trunk and arms/limbs, both spontaneous and triggered by sensory stimulations, emerging in relaxed wakefulness typically during the transition between wake and sleep. Generally, PSM originates from a thoracic myelomere and spreads caudally and rostrally, provoking flexion and/or extension movements, leading to jumps or trunk jerks. They appear triggered by the lying-down position and disappear when the subject stands up.

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Background: Insomnia Disorder is characterized by high degree of phenotypic heterogeneity, that might influence treatment response.

Methods: 123 of 294 insomnia patients initially recruited (66.7% females, age=40.

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Objective: Restless legs syndrome (RLS) is a sleep disorder characterized by an urge to move legs or arms, with a typical circadian rhythm. RLS can be treated with pharmacological and non-pharmacological therapies. Nevertheless, in some patients RLS can be refractory to all medical and non-medical treatments.

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Rapid Eye Movement (REM) sleep is involved in nightly emotional processing; therefore, its disruption might be associated with an impaired ability of emotional regulation during daytime. Accordingly, the aim of the present study was to evaluate the presence of emotional dysregulation in insomnia patients and to test its correlation with REM sleep features. Forty-six subjects (23 insomnia patients and 23 healthy controls) were enrolled.

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